Kidney stones occur when solid salt and minerals accumulate inside the kidneys. Typically, kidney stones develop as urine becomes concentrated, causing crystalline minerals such as calcium, uric acid, and oxalate to gel and stick together. Accordingly, kidney stones can affect some areas of the urinary tract, including the bladder, from the kidneys. The main causes of kidney stones include age, lifestyle, pre-existing medical conditions or external seasonal factors. In particular, one should be extra careful in summer, as intense heat can increase the risk of kidney stones due to sweating and rapid loss of uric acid in the urine. Accordingly, the kidneys maintain body water levels through concentrated urine, which leads to the formation of stones in the kidneys. Therefore, individuals should replenish normal fluid loss during the summer through proper hydration to reduce the risks.Also read – Symptoms of diabetes: How your skin can warn you before it’s too late to reverse diabetes!
Reasons
- Heat-related dehydration: Inadequate daily water intake and excessive sweating can increase the risk of dehydration and related kidney stones. In particular, individuals living in warmer climates or arid climates are more at risk.
- Age: In general, kidney stones affect older middle age groups due to the accumulation of calcium. However, recent lifestyle factors, including obesity in the younger population, increase the risks in all age groups.
- Diet: High protein, salt and sugar intake may increase the risk of kidney stones. In particular, too much salt increases calcium levels to filter the kidneys, which increases the risk of developing stones.
- Excess weight: Excess body weight / mass and obesity can cause kidney stones.
- Pre-existing medical conditions: Certain medical conditions and surgeries increase the risks. For example, digestive disorders such as chronic diarrhea, inflammatory bowel disease or gastric bypass surgery. These conditions alter the digestive process, affecting the absorption of calcium and water, which increases the amount of stone-forming substances in the urine. Similarly, patients with regular urinary tract infections, hyperparathyroidism, cystinuria or renal tubular acidosis are at risk. Certain dietary supplements, including vitamin C, calcium-based antacids, laxatives, or antidepressants for depression and migraine, increase certain risks.
Features
In general, kidney stones show no visible symptoms. However, the movement of stones inside the kidneys or stones in the urethra or the tubes connecting the kidneys and bladder can disrupt the flow of urine and cause inflammation in the kidneys. Therefore, common onset symptoms include stabbing pain in the lower, side and back of the ribs. Also, inflammation and pain can occur during urination. Other symptoms include urinary abnormalities such as excessive urination, red, brown or pink, cloudy and smelly urine. However, timely medical attention is needed for severe pain, blood or urinary incontinence, pain with fever, cold and nausea symptoms. Also read – Lifestyle changes that can help control arthritis – what does the scientific evidence tell us?
Treatment
Doctors may perform relevant diagnostic tests such as blood, urine and image tests such as ultrasound or CT scans for the required treatment, as well as lab analysis of the stones for the required treatment. Treatment options depend on the size and cause of the kidney stones. Most of the time, small stones and minimal symptoms do not require aggressive treatment. Instead, the doctor may recommend drinking 1.8-3.6 liters of water to dilute the urine and prevent stone formation and to take pain relief medications to relieve the discomfort symptoms while passing small stones. Finally, the proposed alpha-blocker drugs that relax the urethral muscles and help pass kidney stones are another non-invasive treatment option. Also read – 5 Reasons Why Your Child Should Be Vaccinated Against Covid-19
Alternatively, extensive treatment options are needed with large and difficult stones due to symptoms of severe visible bleeding, kidney damage, or regular urinary tract infection. Primarily, sound wave procedures, ESWL (extracorporeal shock wave lithotripsy) and laser lithotripsy procedures can help break down stones. RIRS (retrograde intrarenal surgery) is the most advanced treatment that involves no incisions (cuts), a flexible ureteroscope is used to locate the stone and a laser is used to break it inside the body. After processing with a laser, the stone is removed by means of recovery devices to remove large pieces of stone and the small pieces come out manually with urine. Expansion devices and access sheaths may be used during ureteroscopy procedures.
(Inputs by Dr. T. Manohar, Chairman, SCUG: Silicon City Urology Group, Urologist – Endurologist, Laser and Laparoscopic Surgeon, Robotic Surgeon and Renal Transplant Surgeon)
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